| NPI | 1124375126 |
|---|---|
| Other Name | HALF DENTAL |
| Entity Type | Organization |
| Authorized Contact | TERESA L RENNELS Office Manager 360-694-4253 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: WA DE60096080) |
| Enumeration Date | 2012-08-08 |
| Last Update Date | 2012-08-08 |